Hepatic Fibrogenesis

Fibrogenesis is the natural wound-healing response to tissue injury. Scar tissue is produced in an effort to limit and encapsulate the area of injury. While acute injury activates fibrogenic pathways, it is when hepatocellular injury is persistent that significant fibrosis accumulates, ultimately leading to the development of cirrhosis. The transformation of normal to fibrotic liver and then cirrhosis is a complex process involving key components, including both hepatic parenchymal and non-parenchymal cells, the immune system, cytokines, proteinases and their inhibitors. This chapter is an overview of our current understanding of hepatic fibrogenesis and provides a framework to understand non-invasive markers of fibrogenesis and potential antifibrotic strategies.